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Master Thesis

Évolution de la fonction ventriculaire droite dans les 3 premiers jours d’un syndrome de détresse respiratoire aiguë : une étude pilote

Abstract : Almost 30% of the patient with acute respiratory distress syndrome (ARDS) develop an acute cor pulmonale (ACP), pejorative prognostic factor. The hemodynamic monitoring by transesophageal echocardiography (TEE) of these patients enables to diagnose ACP and adapt the treatment to limit the hemodynamics consequences. The occurrence of this right dysfunction is unknown. The purpose of our study was to report the evolution of the right ventricule (RV) function during the early hours of ARDS with miniature and disposable TEE probe. Prospective observational study of current care in 3 intensive care units. A systematic evaluation was made at H0, H6, H12, H18, H36, H48, H60 and H72 after inclusion. RV dilatation, paradoxical septum, ACP, left ventricular dysfunction, and respiratory variation of superior vena cava were recorded The hemodynamic and respiratory settings and the blood gas were also recorded as well as treatment modifications after the TEE. Twenty-eight patients were included. There were 43% of patients with ACP, with a peak at 48 hours. 71% of the patients showed RV dilatation but it seems not related with the apparition of a ACP Around half of the patients benefit from treatment modifications after TEE evaluations. ACP occurrence is frequent and not predictable which justifies a repeated TEE monitoring in the early hours of severe ARDS to optimize treatment.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01293919
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Submitted on : Friday, March 25, 2016 - 4:45:57 PM
Last modification on : Friday, March 27, 2020 - 2:52:55 AM
Long-term archiving on: : Sunday, June 26, 2016 - 3:18:56 PM

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  • HAL Id : dumas-01293919, version 1

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Alix Le Bot Aubry. Évolution de la fonction ventriculaire droite dans les 3 premiers jours d’un syndrome de détresse respiratoire aiguë : une étude pilote. Médecine humaine et pathologie. 2015. ⟨dumas-01293919⟩

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